Letter from the Editor
Our family recently celebrated the 100th birthday of my Aunt Ruth. This makes her
an anomaly in two ways.
The first is that she has reached an age very few of us will achieve. While the number
of American centenarians has been on the rise—up 44% in recent years, from 50,281
in 2000 to 72,197 in 2014 (the latest year for which I could find statistics), that’s still a
minuscule portion of the population, a fraction of a fraction of one percent.
The second anomaly is more relevant to our industry. It’s a widely-accepted fact that a
vast amount of our healthcare dollars are spent on patients in the last few years of life.
But Aunt Ruth is not one of those putting pressure on our healthcare system. Until re-
cently, she lived on her own, without regular help of any kind. It was only just before her hundredth birthday
that she moved to an assisted living facility because her blood pressure is low and she occasionally gets dizzy.
Still, Aunt Ruth refuses to take medications (and please don’t tell her I revealed her age, which she strives to
Of course, the shift in dollars toward end-of-life care is due to several factors. One is the enormous advances
that have been made in medical treatments of all kinds that extend life. Some of these just put off the inevitable for a few months at most, but others stave off the end indefinitely, and many add to quality of life as well.
Then there’s the burgeoning industry of hospice, in-home nursing, assisted-living, ‘round-the-clock care and
other services that tend to our physical and emotional needs as we decline.
This is a tribute to the innovation and energy of our industry. It brings with it some controversy, of course.
How long do we really want to extend the lives of people who have no discernible quality of life anymore, or
little hope? To use another example from my family, take my father-in-law, who was a physician. At 88, he
was found to have a type of cancer that would require aggressive treatment. Knowing the odds, and declaring “I’ve lived a good life,” he refused nutrition, gathered the family for a last goodbye, and died rather peacefully a couple of weeks later.
What does all this tell us? I guess that, along with the miraculous forward march of medicine, we still have
choices to make. And that, I think, is part of the patient-centricity topic we discuss in this issue. After all,
what’s more patient-centric than becoming educated and taking more control of our own healthcare?
As always, we continue to look for the value of your contributions. Let us know if you have an idea for an
article—the people we write for are the people who write for us.
Neil Greenberg, Editor
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